What Fresh Hell Is This?

Friday, January 19, 2018

On December 22, 2017 I went in for what I thought was my annual CT scan.  I’ve done a lot of these and they are pretty easy.  Dr. Ko calls them my “low dose radiation treatment.”  On December 26^th I saw Dr. Bomzer for the follow up appointment.  I see him every six months.

It hadn’t always been like that.  After my surgery on May 19, 2010 to remove the Bronchial Associated Lymphoid Tumor (BALT), I saw him every three months with CT scans each time.  Gradually they went to every four, then six.  When I asked if it would eventually be annual visits, he told me “No, we will see each other every six months forever.”  He’s a pretty conservative doctor, and my colon cancer in 1992 and our family history pretty much guaranteed close monitoring..  I’m ok with it.

That surgery went fine.  They removed the tumor, analyzed it, determined that it was cancerous, removed the rest of that half lung, and that was that.

When I saw Dr. Bomzer on December 26th, 2017, he said that the radiologist flagged a lesion in my right lung that had changed since 2014.  He said that it had definitely changed since 2010, the first scan that I had.  He said that I needed to see a pulmonologist to determine the next course of action and referred me to Dr. Al-Saghir.

On January 16th, 2018 Laurie and I went to see her.  The Pulmonology Department of a hospital has a lot of sick people in it.  There are a lot of oxygen tanks and wheezing.  As our friend Pat would say, “There is no happiness there.”  It’s unbelievable that people still smoke.

Dr. Al-Saghir is quite matter of fact – no small talk or mincing words, at least during this initial visit.  She said that we need to do a biopsy, but the area in question is in a difficult spot to get to.  The fact that the area is small is good for me, but bad for access.  I’ll take small.    Bronchoscopies have improved quite a lot since 2010, and she may be able to that way, but will need another CT scan to determine how that could be done.  The alternative is to go surgically through the side into the lung.  That poses a higher risk of “lung collapse” – 2 to 4%.  That sounded bad to me, but she said it’s not that big a deal.  It would mean an overnight stay in the hospital, but the lung usually just closes itself up.  Still sounds scary.  Both are out-patient procedures and require a general anesthetic.

Dr. A said there were four possibilities as to what it could be:

·         Scar tissue.  That seems pretty unlikely to me.  Why would scar tissue grow?

·         Infection.  Also seems unlikely, but what do I know.  They would treat that with some sort of antibiotic.

·         Lymphoma.  That’s what I had before and she said it would probably be treated with radiation and/or chemotherapy.

·         Lung Cancer.  That would mean surgery.  She said that there is a form of lung cancer that nonsmokers, and some smokers, get.  It’s a less aggressive form that what smokers typically get.

Dr. Bomzer also mentioned that whatever I have, it’s “low-grade,”

When you are sitting in a doctor’s office for an appointment like that, a lot goes through your mind.  You listen, trying to take in the totality of the discussion, but also trying to hear what isn’t said.  But words like “radiation,” “chemotherapy,” and “lung cancer” have a chilling effect, making it difficult to concentrate.  I had a lot of questions on the drive home, but couldn’t think of a single one at the time.

When we left her office, Laurie wanted to go to the gift shop.  I knew she was a little freaked out.  She wasn’t expecting to see and hear what we did.  Later that evening she told me that she could not ask any questions because she was “devastated.”

I had the “high contrast chest CT scan ”  on January 19th.   It went quick, as always.  This one was different in that they took pictures while exhaled and well as with the lungs full, and while I was on my stomach.  The tech said that the radiologist would ready the scan today and get the results to Dr. Al-Saghir no later than Tuesday.  She said that she will call me once she has a chance to review them and we’ll determine a course of action.